Current jobs related to Specialist Technical Denial - Erlanger - St. Elizabeth Healthcare

  • Logistics Specialist

    4 weeks ago

    Erlanger, Kentucky, United States STS Technical Services Full time

    STS Technical Services: Sr. Logistics SpecialistWe are seeking a highly skilled Sr. Logistics Specialist to join our team in Erlanger, Kentucky. In this role, you will be responsible for resolving complex issues related to transportation, logistics systems, imports, and exports. You will ensure all shipments comply with company policies, procedures, and...

  • Technical Support Specialist

    3 weeks ago

    Erlanger, Kentucky, United States Insight Global Full time

    Job Title: Technical Support SpecialistThis role is responsible for providing technical support to our clients while managing the status of all incidents and requests. The successful candidate will report to the PC Support Supervisor and the Sr. Manager of IT End User Support.Key Responsibilities:Proactively identify, research, and resolve technical...

  • Aircraft Maintenance Controller

    2 weeks ago

    Erlanger, Kentucky, United States STS Technical Services Full time

    Job Title: Senior Aircraft Maintenance Controller Job Summary: STS Technical Services is seeking a skilled Senior Aircraft Maintenance Controller to join our team. As a key member of our maintenance team, you will be responsible for reviewing maintenance discrepancies and developing action plans to minimize delays. Key Responsibilities: * Coordinate...

  • Senior Aircraft Maintenance Controller

    1 month ago

    Erlanger, Kentucky, United States STS Technical Services Full time

    Job SummaryWe are seeking a highly skilled Senior Aircraft Maintenance Controller to join our team at STS Technical Services. As a key member of our maintenance team, you will be responsible for ensuring the safe and efficient operation of our aircraft.Key ResponsibilitiesCoordinate maintenance activities with vendors and internal departments to ensure...

  • Senior Aircraft Maintenance Controller

    2 months ago

    Erlanger, Kentucky, United States STS Technical Services Full time

    Job Summary:We are seeking a highly skilled Aircraft Maintenance Controller to join our team at STS Technical Services. As a key member of our maintenance operations team, you will be responsible for ensuring the safe and efficient maintenance of our aircraft fleet.Key Responsibilities:Coordinate Maintenance Activities: Work closely with our vendors and...

  • Aircraft Maintenance Controller Specialist

    2 weeks ago

    Erlanger, Kentucky, United States STS Technical Services Full time

    Job Summary:STS Technical Services is seeking a highly skilled Senior Aircraft Maintenance Controller to join our team. The ideal candidate will have a strong background in aircraft maintenance and a proven track record of coordinating maintenance activities with vendors and internal departments.Key Responsibilities:Coordinate maintenance, tooling, and parts...

  • Data Integration Specialist

    1 week ago

    Erlanger, Kentucky, United States Archer Daniels Midland Company Full time

    Job Title: Data Integration SpecialistJob Summary: We are seeking a highly skilled Data Integration Specialist to join our team at Archer Daniels Midland Company. The successful candidate will be responsible for translating functional requirements into technical requirements and developing those technical requirements into code and interfaces.Key...

  • Logistics Coordinator

    3 weeks ago

    Erlanger, Kentucky, United States PEAK Technical Staffing USA Full time

    Job SummaryWe are seeking a highly organized and detail-oriented Logistics Specialist to join our team at PEAK Technical Staffing USA. The successful candidate will be responsible for handling customer service and documentation related to imports and exports.Key ResponsibilitiesImport & Export Documentation & HandlingProvide exceptional customer service...

  • Senior Desktop Support Specialist

    3 weeks ago

    Erlanger, Kentucky, United States Futran Tech Solutions Pvt. Ltd. Full time

    Job Title: Senior Desktop Support SpecialistFutran Tech Solutions Pvt. Ltd. is seeking a highly skilled Senior Desktop Support Specialist to join our team.Key Responsibilities:Handle first point escalation for all technical and process issues of Warehouse Distribution Centre.Provide technical subject matter expertise wherever required.Ensure proper...

  • Informatica Developer

    7 days ago

    Erlanger, Kentucky, United States Archer Daniels Midland Company Full time

    Job Title: Informatica Developer - MDM SpecialistJob Summary: We are seeking an experienced Informatica Developer to join our team at Archer Daniels Midland Company. The successful candidate will be responsible for designing, developing, and implementing Master Data Management (MDM) solutions using Informatica MDM.Key Responsibilities:Translate functional...

  • Maintenance Specialist

    7 days ago

    Erlanger, Kentucky, United States Candlewood Suites South Cincinatti Full time

    Job SummaryCandlewood Suites South Cincinnati seeks a skilled Maintenance Specialist to join our team. As a key member of our facilities team, you will be responsible for ensuring the smooth operation of our hotel's mechanical systems, equipment, and structures.Key Responsibilities:Perform routine maintenance tasks, including inspecting and repairing...

  • Customer CAPA Specialist

    1 month ago

    Erlanger, United States ADM Full time

    Job Description Customer CAPA Specialist - Erlanger, KYJob Summary: The Customer CAPA Specialist role is a global technical execution position that is responsible to ensure effective investigations and corrective and preventative actions are identified and addressed as a result of reactive and proactive product quality and service issues that impact our...

  • Customer CAPA Specialist

    2 weeks ago

    Erlanger, United States Hiring Now! Full time

    Job Description Customer CAPA Specialist - Erlanger, KYJob Summary: The Customer CAPA Specialist role is a global technical execution position that is responsible to ensure effective investigations and corrective and preventative actions are identified and addressed as a result of reactive and proactive product quality and service issues that impact our...

  • Dangerous Goods Specialist

    2 weeks ago

    Erlanger, Kentucky, United States DHL Express, Inc. Full time

    Job Title: Dangerous Goods SpecialistAt DHL Express, Inc., we are committed to maintaining a safe and compliant environment for our employees and customers. We are seeking a highly skilled and experienced Dangerous Goods Specialist to join our team.Key Responsibilities:Provide regulatory and operational direction to field operations, customer support, and...

  • Forklift Equipment Repair Specialist

    3 days ago

    Erlanger, Kentucky, United States ProLift Toyota Material Handling Full time

    Job SummaryWe are seeking a skilled Forklift Equipment Repair Specialist to join our team at ProLift Toyota Material Handling. As a key member of our team, you will be responsible for efficiently performing quality repairs on all classes of forklifts and industrial equipment.Key Responsibilities:Ensure proper maintenance and repair is performed on ProLift...

  • Customer Quality Assurance Specialist

    4 weeks ago

    Erlanger, Kentucky, United States Archer Daniels Midland Company Full time

    About the RoleWe are seeking a highly skilled Customer Quality Assurance Specialist to join our team at Archer Daniels Midland Company. As a key member of our global technical execution team, you will be responsible for ensuring effective investigations and corrective and preventative actions are identified and addressed as a result of reactive and proactive...

  • Customer Quality Assurance Specialist

    3 weeks ago

    Erlanger, Kentucky, United States Archer Daniels Midland Company Full time

    Job Title: Customer Quality Assurance SpecialistAt Archer Daniels Midland Company, we are seeking a highly skilled Customer Quality Assurance Specialist to join our team. This role is responsible for ensuring effective investigations and corrective and preventative actions are identified and addressed as a result of reactive and proactive product quality and...

  • Quality Food Safety Specialist

    4 weeks ago

    Erlanger, United States ADM Full time

    Job Description Quality Food Safety Specialist - Erlanger, KYMAIN FUNCTION:You will be responsible for managing and supporting Food Safety programs. You will conduct routine audits of the facility and outside storage facilities including food safety and the warehouse. You will also monitor physical, chemical, and biological food safety hazards and implement...

  • Sensory Quality Control Specialist

    2 weeks ago

    Erlanger, Kentucky, United States ADM Full time

    About the RoleWe are seeking a highly skilled Sensory Quality Control Specialist to join our team at ADM. As a key member of our Quality team, you will be responsible for providing sensory support for our Erlanger laboratory, implementing training programs for technicians, and driving organoleptic accuracy.Key ResponsibilitiesPlan, coordinate, and implement...

  • Customer CAPA Specialist

    4 weeks ago

    Erlanger, United States Archer Daniels Midland Company Full time

    Job DescriptionCustomer CAPA Specialist - Erlanger, KYJob Summary: The Customer CAPA Specialist role is a global technical execution position that is responsible to ensure effective investigations and corrective and preventative actions are identified and addressed as a result of reactive and proactive product quality and service issues that impact our...

Specialist Technical Denial

2 months ago

Erlanger, United States St. Elizabeth Healthcare Full time

Engage with us for your next career opportunity. Right Here.

Job Type:

Regular

Scheduled Hours:

40

Job Summary:

The Technical Denials Specialist is responsible for analyzing, resolving, monitoring and reporting non-clinical denials to Denials Unit Manager as appropriate. The Technical Denial Specialist is responsible for follow-up and resolutions for denials escalated through a work queue, providing appropriate denial information to be submitted to departments to ensure systems, processes and measures of effectiveness (e.g. Remediation action plans) are created and implemented to resolve root cause issues and reduce/ eliminate denials. The Technical Denial Specialist should remain in full compliance with all departmental, institutional and regulatory policies and procedures at all times. The roles and responsibilities of this job support the mission, vision, values and strategies of St. Elizabeth Healthcare.

Demonstrate respect, dignity, kindness and empathy in each encounter with all patients, families, visitors and other employees regardless of cultural background.

Job Description:

  • Reviews, researches and addresses non-clinical denials. 
  • Addresses all accounts assigned to work queue and completes all necessary activity as defined in departmental policies and procedures.
  • Performs extensive follow-up, completes appeals and referrals to other stakeholders, when appropriate. 
  • Investigates and/or ensures that questions and requests for information are responded to in a timely and professional manner to ensure resolution of outstanding accounts. 
  • Performs ongoing monitoring of denials accounts worked, as necessary, to ensure maximization of collection dollars by providing appropriate follow-up and documenting actions taken.
  • Utilizes all appropriate systems to effectively research accounts and complete steps to submit information necessary to process or appeal accounts. 
  • Completes follow-up with patients, as necessary, to obtain additional information. 
  • Prepares necessary documentation to submit appeals to payers when payment is denied. 
  • Complete all necessary outgoing calls and answer incoming calls, as appropriate.
  • Make revisions or changes to insurance information, as appropriate. 
  • Requests the rebilling accounts as necessary. 
  • Complete and/or request adjustments to an account, as appropriate, based on adjustment thresholds. 
  • Reviews, works and reports (with accuracy) all accounts that have aged more than the specified grace period stipulated in the policies and/or contracts. 
  • Documents follow-up or patient accounts appropriately. 
  • Tracks and reports violation of prompt pay/adjudication terms by payers and follows up proactively with payers to provide necessary additional documentation for patient accounts that have been reviewed by payers and awaiting documentation to determine adjudication
  • Interfaces with other key internal and external staff to obtain necessary information to address payment variance management issues or requests. 
  • Reports issues and trends to appropriate management personnel and works collaboratively to develop solutions. 
  • Reports issues and trends to appropriate management personnel and works collaboratively to develop solutions.
  • Participates in all educational activities and demonstrates personal responsibility for job performance. 
  • Meets or exceeds expectations for data quality, customer service, payment variance management turnaround and productivity. 
  • Maintains satisfactory attendance record and punctuality record as set forth by St. Elizabeth Healthcare and departmental policies. 
  • Consistently demonstrates a positive and professional attitude at work. 
  • Maintains stable performance under pressure.
  • Prioritizes work/resources to accomplish objectives and meet deadlines
  • Maintains compliance with federal, state and local regulations and HIPPA. 
  • Maintains the privacy and security of all confidential and protected health information; job duties warrant a “high” level of computer system access (all necessary areas) to patient information ONLY for those job functions as outlined in this job description; uses and discloses only that information which is necessary to perform the function of the job. 
  • Performs other duties as assigned.

Education, Credentials, Licenses:

  • Associates degree

OR

  • High School Diploma plus Certified Revenue Cycle Representative and 3 years of related experience.

Specialized Knowledge: 

  • Demonstrates proficiency in Microsoft Office applications and others as required
  • Demonstrates knowledge and understanding of organizational policies, procedures
  • Knowledge of insurance regulations, payment guidelines and policies and the ability to communicate and work with payors to get accounts resolved and paid accurately
  • Extensive knowledge of Medicare and Medicaid regulations
  • Knowledge of third Party claim filing, contract reimbursement  and other insurance guidelines

FLSA Status:

Non-Exempt

Right Career. Right Here. If you're looking for the right careers in healthcare, the right place to be is at St. Elizabeth. Join us, and you'll take pride in the level of care we offer our community.